Big red “X”

It has come to my attention that there is a big red “X” on my forehead that everyone else can see but me. For the last few weeks, my nights at work are ending quite strangely with psychotic patients.

Let’s recap some of the highlights starting with my patient tonight …

Tonight I had a patient who was in the hospital a week prior to his surgery. He had at least 5 different doctors overseeing his care and at least 5 different sets of orders … many of which were conflicting. In fact, the doctors could not even agree about where to send this patient from recovery. The only thing they all agreed upon is that the patient should go to some sort of ICU.

After 3 or 4 different people stuck fingers on where my patient would end up tonight, my patient was growing quite angry. Randomly, his wife showed up at the hospital to tell us that no one had updated her during the entire surgery or afterwards and wanted to know what was going on. I brought her in to sit with my patient, and I am not sure that helped any whatsoever. He became irate, started cussing at me continuously, told me to shut up on numerous occasions and asked if there were any metal pieces in my body so that he could shove them in farther. He said he wanted to strangle the nurse next to me because she was too loud. He refused to wear oxygen and kept ripping off his dressing. He threatened to leave the hospital, and by this point I was tired of him so I told him to go if he wanted to.

Of course, he did not leave, and I had to put up with him for hours on end. His wife left and made me endure this asshole completely alone. The other nurses all had patients, so I had to deal with this lunatic. I had him not for one hour, but for 4 hours! Four hours of one-on-one care … 4 hours of complete torture. There are not enough drugs in the world to keep this patient quiet. All he did was … bitch, bitch, bitch.

Another lovely example …

I tend to be the lucky recipient of numerous pain clinic patients. I do not think other nurses have the patience for them, so I think I just “sort of magically end up” with them. Yeah … I bet that is how it happened …

So, back to the story, I got a lovely lady who was a chronic pain patient having surgery for a pain pump installed in her body. She arrived in recovery flipping like a mad woman on her stretcher, pulling at all her monitors and IV, screaming at the top of her lungs. I did what any nurse would do … I MEDICATED. I grabbed everything out that I was able to give and gave it within a 30 minute period. Then, I had the physician write for additional meds. The patient was still squirming and screaming. I called her husband in, and I made him deal with her for a while.

The woman started scratching her skin raw. She was clawing at every ounce of flesh on her body. And, let’s just say, she had a lot of ounces to scratch. I tried to give her lotion and anything I could think to make her stop shredding her skin. Finally, I got some Benadryl. Who would have thought that Benadryl would have been the drug to knock her out?

No joke. Thank goodness the husband was there as a witness. I gave the woman Benadryl and she became narcoleptic. There was no way to keep her awake. With her horrible sleep apnea, she could not maintain her O2 sats. I kept her in recovery for a total of 3 hours. She was maintaining an O2 sat >95% upon leaving recovery.

By the time we reached the floor, the patient would not maintain a sat above 85% without constant stimulation. The floor refused to take her. I called anesthesia to assess to see if Narcan was warranted. Anesthesia said that since all narcotics were last given 2 hours earlier that this was completely the fault of Benadryl. The anesthesiologist refused to admit the patient to ICU for monitoring for Benadryl. He said basically all she needs is stimulation. Rather than to call an additional nurse in to babysit a patient, I got the floor to agree to let me stay in the room and keep her awake myself. Her husband decided to leave and patted me on the back and said, “good luck!”

Let’s just say that I spent 3 hours annoying a patient to tears. I jumped on her bed while she was in it. I blasted her TV on the music station and danced like a crazy fool … including the chicken dance and the worm. I walked like a zombie for 5 minutes straight begging to eat her “BRRRRAAAIIINNS!” I let her tell me all about her abuse as a child. It was maddening. Finally, the floor cleared me to leave … especially considering the patient was breathing at 99% and begging for more pain medicine by the end of my stay.

Another fine example …

Oh yes, this was another pain clinic patient. Seeing a pattern here? The man arrived in the recovery room asking me if “they returned him to the right body.” He told me that he was invisible and could not see himself. He asked me if I could see him. He decided he needed to pee, but since he was invisible he could not find his own penis. So, I pulled it out and stuck it in a urinal for him. He told me he could feel me touching him inappropriately and asked me to leave. He told me I was watching him and it was not right of me.

Needless to say, it took a lot longer to recover this patient than it should have. I later learned he was given ketamine in the OR … kind of an important detail to leave out in report!

Time to retire???

No one better mess with this nurse. I take crap from everyone at work (quite literally at times). I refuse to take it from the other people in my life. I can only be so nice. Spend one day in my shoes … 12 hours in my job. This is not something that everyone can handle. A nurse has a very difficult job. I am just mentioning incidents of crazy patients, but I have way more stories of dealing with other nurses, doctors, families, etc. My job, quite often, SUCKS ASS! Yes, I said it. It is time for me to retire …

Random musing …

While the rest of you former bloggers are wasting all your time with Twitter, Facebook, Google Plus, etc., let it be know that I will continue to have diarrhea of the mouth right here! While occasionally on some of those other sites too ;)